Orange County has the only center in Florida with a proven history of keeping the mentally ill in treatment and out of jail and emergency rooms.Since it opened in 2003, the Central Receiving Center has also saved taxpayers and hospitals an estimated $50 million.

Now Osceola County wants to do the same thing, but a for-profithospital's objection could scuttle what advocates contend is a valuable service to the mentally ill and law enforcement.

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Osceola Regional Medical Center opposes a waiver that would require law enforcement to bring the mentally ill directly to the proposed Central Receiving Center at Park Place Behavioral Healthcare in Kissimmee.

"The granting of a transportation exemption to divert psychiatric patients from the nearest receiving center to Park Place is a blatant financially motivated maneuver to benefit only Park Place," the hospital's attorneys wrote the Florida Department of Children & Families, which is reviewing the waiver request.

Without the transportation waiver, police and sheriff's deputies would be required by law to bring a mentally ill person to the nearest facility — either Osceola Regional or Park Place, which are one mile apart. The head of Park Place contends the waiver is essential for the success of its mission, and would kill the facility that's been in the works for five years.

"This is really a crucial issue for us," said James Shanks, Park Place CEO.

The Central Receiving Center handles only those who are picked up by law enforcement under the Baker Act because they are a danger to themselves or others.

The bottom line is money. Both Osceola Regional and Park Place need Baker Act patients with health care insurance to compensate for those who are indigent. Sixty percent of the hospitals psychiatric ward patients have insurance while 60 percent of Park Place's mentally ill patients are indigent.

If Osceola Regional loses too many paying customers to Park Place, it could jeopardize something Osceola County desperately needs — a hospital that treats the mentally ill with medical problems.

"This is a piece that was never available in Osceola County," said Michele Reed, program director of the hospital's new Behavioral Health Center. "We were not able to take care of those patients in our county."

The hospital's letter to DCF states that Osceola Regional spent millions of dollars to build its 25-bed Behavioral Health Center, an intake area, and two safe rooms for Baker Act patients in the hospital emergency department. Hospital officials say the psych wing has been at capacity since it opened on Dec. 8 with the majority of the patients brought to the hospital by law enforcement.

If Park Place loses too many paying customers, it can't make enough money to cover the cost of its indigent patients. Until Osceola Regional obtained Baker Act receiving status in December, Park Place was the only facility in Osceola for 30 years approved to take Baker Act individuals.

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"If we lost those insured patients, we wouldn't be able to survive," Shanks said.

Shanks said construction of the $1.4 million receving center depends on the waiver from DCF, which has had the application for three months. A spokesperson for the local DCF office said the waiver request was sent to Tallahassee last week and the delay had nothing to do with the hospital's opposition to the waiver.

The Osceola County Commission has endorsed the creation of the Central Receiving Center. So have law-enforcement officials.

"It's the right thing to do. It will be a lot more efficient and convenient for law enforcement," said Osceola County Sheriff Robert Hansell, who serves on the Park Place board of directors along with judges, government officials and an executive of Osceola Regional. "Our jails are starting to be our central receiving facilities. That is what we are trying to eliminate."

But not everybody is so sure. Kissimmee Police Chief Lee Massie said he is uncertain which is better for his department: one CRC or two designated Baker Act facilities.

"If I can get them to the proper location and get them the treatment they need and my officer back on the street for public safety, that is my focus and my only focus," Massie said.

Even if everyone under the Baker Act is taken to the Park Place receiving center, not all would end up there. Those with problems that require medical treatment would be transferred to Osceola Regional. So would anyone who requests placement at the hospital, or is referred to Osceola Regional for treatment by physicians, mental health professionals, or family members.

Reed contends there is enough of a need for mental health care in Osceola for both Osceola Regional and Park Place: "I don't think of it as competition. I see it as collaboration. There is plenty of business for all of us."